The perceptions of general practice among Central and Eastern Europeans in the United Kingdom: A systematic scoping review

Journal article

Poppleton, A., Howells, K., Adeyemi, I., Chew‐Graham, C., Dikomitis, L. and Sanders, C. 2022. The perceptions of general practice among Central and Eastern Europeans in the United Kingdom: A systematic scoping review. Health Expectations. https://doi.org/10.1111/hex.13433
AuthorsPoppleton, A., Howells, K., Adeyemi, I., Chew‐Graham, C., Dikomitis, L. and Sanders, C.
Abstract

Background
Around 2 million people have migrated from Central and Eastern Europe to the UK since 2004. The UK Central and Eastern European Community (UK-CEE) are disproportionately exposed to the social determinants of poor physical and mental health. Their health and healthcare beliefs remain under-researched, particularly regarding primary care.

Objective
This review explores UK-CEE community members' use and perceptions of UK general practice.

Methods
A systematic search of nine bibliographic databases identified 2094 publications that fulfilled the search criteria. Grey literature searches identified 16 additional relevant publications. Screening by title and abstract identified 201 publications of relevance, decreasing to 65 after full-text screening. Publications were critically appraised, with data extracted and coded. Thematic analysis using constant comparison allowed generation of higher-order thematic constructs.

Results
Full UK-CEE national representation was achieved. Comparatively low levels of GP registration were described, with ability, desire and need to engage with GP services shaped by the interconnected nature of individual community members' cultural and sociodemographic factors. Difficulties overcoming access and in-consultation barriers are common, with health expectations frequently unmet. Distrust and dissatisfaction with general practice often persist, promoting alternative health-seeking approaches including transnational healthcare. Marginalized UK-CEE community subgroups including Roma, trafficked and homeless individuals have particularly poor GP engagement and outcomes. Limited data on the impact of Brexit and COVID-19 could be identified.

Conclusions
Review findings demonstrate the need for codesigned approaches to remove barriers to engagement, culturally adapt and develop trust in GP care for UK-CEE individuals.

Community Involvement
Community members and stakeholders shaped the conceptualisation of the review question and validation of emergent themes.

KeywordsGeneral Practice; GPs; Emigration ; Immigration; European Union; Delivery of healthcare
Year2022
JournalHealth Expectations
PublisherWiley
ISSN1369-6513
1369-7625
Digital Object Identifier (DOI)https://doi.org/10.1111/hex.13433
Official URLhttps://onlinelibrary.wiley.com/doi/10.1111/hex.13433
FunderWellcome Trust
Publication dates
Online19 Jan 2022
Publication process dates
Accepted29 Dec 2021
Deposited31 Jan 2022
Publisher's version
License
Output statusPublished
Additional information

Wellcome Trust. Grant Number: 203921/Z/16/Z

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